CAJ | 학술논문

目的：探讨C形臂碘油CT在肝癌肝动脉化疗栓塞术（TACE）中的应用价值。方法对40例肝癌患者，先行64层CT扫描，再行TACE术。术中先行数字减影血管造影（DSA），然后注入超液态碘化油行诊断性栓塞，即刻行C形臂CT平扫，如发现有明确的肝癌病灶，再经微导管超选择插至病灶的肿瘤供养血管并注入明胶海绵颗粒栓塞。TACE术后7~14 d 内复查CT（碘油CT）。由4名医师分别对64层CT、DSA、C形臂碘油CT和碘油CT的图像进行读片，并对肝癌病灶分别计数。以碘油CT的评价标准判断C形臂碘油CT的结果。TACE前后甲胎蛋白（AFP）含量比较采用配对t检验。结果40例患者64层CT发现13个可疑病灶；DSA确诊10个病灶，发现4个可疑病灶；C形臂碘油CT发现71个病灶；碘油CT确诊67个病灶。TACE前后的AFP值分别为（452.3±192.6）μg/L和（223.8±93.2）μg/L，差异有统计学意义（t=2.131，P=0.039）。结论 C形臂碘油CT在TACE术中可早期发现肝癌微小病灶，使患者得到早期治疗。
목적：탐토C형비전유CT재간암간동맥화료전새술（TACE）중적응용개치。방법대40례간암환자，선행64층CT소묘，재행TACE술。술중선행수자감영혈관조영（DSA），연후주입초액태전화유행진단성전새，즉각행C형비CT평소，여발현유명학적간암병조，재경미도관초선택삽지병조적종류공양혈관병주입명효해면과립전새。TACE술후7~14 d 내복사CT（전유CT）。유4명의사분별대64층CT、DSA、C형비전유CT화전유CT적도상진행독편，병대간암병조분별계수。이전유CT적평개표준판단C형비전유CT적결과。TACE전후갑태단백（AFP）함량비교채용배대t검험。결과40례환자64층CT발현13개가의병조；DSA학진10개병조，발현4개가의병조；C형비전유CT발현71개병조；전유CT학진67개병조。TACE전후적AFP치분별위（452.3±192.6）μg/L화（223.8±93.2）μg/L，차이유통계학의의（t=2.131，P=0.039）。결론 C형비전유CT재TACE술중가조기발현간암미소병조，사환자득도조기치료。
Objective To investigate the application value of C-arm lipiodol CT in transhepatic arterial chemoembolization(TACE) for hepatocellular carcinoma(HCC). Methods Totally 40 HCC patients diagnosed clinically underwent transhepatic arterial chemoembolization(TACE) after 64-slice CT. Digital substraction angiography(DSA) was ifrstly done then lipiodol was injected into hepatic arterial for diagnostic embolization during TACE. Then C-arm lipiodol CT was done after diagnostic embolization immediately. If HCC lesions were diagnosed, gelfoam particle was superselective injected into the tumor nourishing blood vessel through microcatheter. Lipioldol CT was performed in 7-14 days after TACE. Images acquired with 64-slice CT, DSA, C-arm lipiodol CT and lipiodol CT were retrospectively reviewed by 4 doctors. The number of detected lesions in each examination was counted respectively. Lipiodol CT images were used as the diagnostic reference for C-arm lipiodol CT. AFP was examined before and after TACE. Results 64-slice CT detected 13 doubtful lesions, DSA detected 10 deifnite and 4 doubtful lesions, C-arm lipiodol CT detected 71 and lipiodol CT detected 67 deifnite lesions. The AFP value was (452.3±192.6)μg/L and (223.8±93.2)μg/L before and after TACE. Statistical difference was found (t=2.131, P=0.039). Conclusion C-arm lipiodol CT can detect micro HCC lesions early in TACE, so the patients can receive early treatment.